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1991-Electric (a/c)
CITY OF OSHKOSH 1�0 24360 � PERMIT - APPLICATION AND RECORD TYPE: BLDG ❑ HTG ❑ ELEC I�I. PLBG ❑ SIGN ❑ ZONING FLOOD PLAIN HEIGHT 7� - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ADDRESS � � � PLAN NO. . OWNER '� ��� DESIGNER USE/NATURE OF WORK , /L�+°"J�- BUILDING CONTRACTOR Size Sq. Ft. # Rooms # Stories Height Foundation Class of Const. Occupancy Permit HEATING CONTRACTOR Heat ❑ NC ❑ Vent ❑ Fuel/System Heat Loss BTU'S FI FC`TRIC` C`ONTRAC'TOR � �� � �� C � �� Electric Serv. New ❑ Change ❑ Temp ❑ Type Volts Amps Fixtures Switches,k_ Receptacles � Circuits � ����� PLUMBING CONTRACTOR BT —WH —Disp —WSoft —CBasin —Lav —Sh —DW DF _San. Sewer —WC —FDr —SP Ur Storm Sewer —Sink —LTub —Eject SS Water Other � o L O � FEES: Valuation $ � Permit Fee Paid $ � � -� / Park Dedication $ ISSUED BY � � i--� Date� '—� � _`( Final/O.P. � ���/ � ��� In the performance of thi or I agree to perform all wor4 ursuant ro rules goveming the described construction. SIGNATURE """ AGENT,OWNEP DA E ADDRESS TELEPHONEif PERMIT NO. � �✓ � �PL. DATE `-' / � �` ELEC CONTR � ��� OWNER ���/��� , /� /�f � ` ADDRESS � NATURE OF WORK ELEC. SERV. NEW CHANGE TEMP . DESC. TYPE VOLTS AMYS FIX S SW S RECEPT' S CIRC' S M APPLIANCES S I G�tS F INAL'��/9`%/ INSP ROUGHIN SERVIC" EST COST / oU`� PERMIT FEE /D ' DATE PD.7 /Y y/ REMARKS